What is self-harm?
Self-harm involves doing things to purposely, physically hurt yourself. It may be done in an effort to cope with distressing thoughts, emotions, or sensations.
If my child engages in self-harm, does it mean they are suicidal?
No, self-harm is not always associated with suicidal thoughts. However, self-harm can sometimes result in serious physical injury, sometimes unintentionally. It is always important to take self-harm seriously; seek guidance from a health-care provider if you suspect or know that a child is self-harming.
What causes thoughts and behaviours of self-harm?
Self-harming thoughts and behaviour often happen due to significant distress – for example, emotions, thoughts or sensations that feel overwhelming or too difficult to cope with in other ways.
Mental health conditions
A number of mental health conditions can increase a child's risk for self-harm. These include:
- depression
- anxiety disorders
- substance use disorders
- some personality disorders (such as borderline personality disorder)
- attention deficit hyperactivity disorder (ADHD)
- post-traumatic stress disorder (PTSD)
- eating disorders such as anorexia, bulimia and binge eating disorder
- bipolar disorder
- schizophrenia
Stressful life events
Stressful events (like a relationship conflict or breakup, academic problems, or family conflict) may lead a child or teen to feel overwhelmed. While some situations may be tolerable, others may be too distressing and exceed an individual’s capacity to cope. Some individuals may be more likely to engage in behaviours such as self-harm in response to difficult life events – such as those who experience emotions very intensely or are already struggling to use safe coping strategies.
What can I do if my child is engaging in self harm?
It may be helpful to speak with your child about what you’re noticing and to express your concern about their safety in a sensitive, non-judgmental way. For example, you can communicate to your child that your primary concern is their safety and well-being and validate the distress they may be experiencing. Let your child know that you’d like to support them in learning to cope safely with the difficult thoughts or emotions they may be experiencing. Talking to your child about these concerns can help to keep lines of communication open. If possible, encourage your child to talk to you about what’s going on – including coming to you if they feel unable to keep themselves safe, or especially if they require medical attention as a result of their self-harm.
It is always important to seek assistance from a trained health-care provider if you know or suspect self-harm. This health-care provider (e.g., your child’s primary health-care provider or a therapist) can help assess risk and make a plan with you/your child to promote safety. They may help your child to build a “coping plan” that includes safer coping behaviours (e.g., using deep breathing, sensory activities or distraction) and instructions for what to do if risk increases.
Seek more immediate help via your child’s primary health-care provider, a poison control hotline, or local Emergency Department if you believe that your child’s safety and well-being are at immediate risk. Risks may include:
- expressed thoughts of suicide
- taking a substance that raises concern about physical harm
- the inability to stop cuts from bleeding
- infection from cuts or injuries.
If your child shows signs of ongoing self-harm, encourage them to take action in seeking medical attention if needed (e.g., calling 911 or taking themselves to hospital if self-injury has resulted in serious physical harm).
How can my child cope with the urge to self-harm?
A child or teen can learn a number of coping strategies to replace long-lasting self-harm behaviours but still relieve distress. These include:
- holding ice cubes on and off the skin for brief periods (30 to 60 seconds)
- using deep breathing or progressive muscle relaxation
- getting a brief amount of high intensity exercise — even 10 to 20 minutes can help
- self-soothing through the five senses, for example:
- looking at pleasant images or watching a relaxing video
- listening to relaxing music or nature sounds
- eating a favourite food for a meal or snack
- wrapping themselves in a soft blanket or taking a bath
- smelling pleasant scents such as scented candles, creams or balms.
- looking at pleasant images or watching a relaxing video
When to seek medical help for self-harm
Speak to your child’s primary health-care provider or pediatrician. A broader assessment of your child’s mental health functioning may be needed, as well as conversations and planning around safety.
Further information
For more information on protecting your child or teen from suicide or self-harm, please see the following pages:
Suicide in children and teens: Overview
Suicide risk: Signs and symptoms
Suicide and self-harm: How to talk to your child about their emotions
Suicide and self-harm: How to protect your child
Please visit our teen mental health website for information on suicide and self-harm.
Resources
In Canada, children and teens in distress can contact KidsHelpPhone on KidsHelpPhone.ca or call 1-800-688-6868.